SLEEP DEPRIVATION EEG & HMPAO-SPECT IN DEPRESSION

说明(改编自申请人的摘要)： 拟议的一系列调查旨在更好地了解 多导睡眠图分析睡眠剥夺的抗抑郁作用 抑郁症患者在PSD治疗前和治疗一晚后的PSG比较 正常对照组。该项目的次要目标包括分析SPECT 这些受试者的脑血流(CBF)数据与 临床变化。研究人员预测：1)抑郁的应答者会 表现出快速眼动潜伏期增加，慢波睡眠增加，以及 PSD后睡眠效率提高；2)应答者CBF异常 在PSD之后，分布将变得不那么异常，以及3) 这些变化将与临床反应的强度相关。 受试者将包括身体健康的男性和女性，诊断为 重度抑郁(单相)，17项汉密尔顿抑郁量表 量表(HDRS-17)和GT；16。正常对照组将在年龄和性别上匹配。 排除标准包括其他精神障碍；怀孕； 可能会因SD而恶化的情况；睡眠障碍；不规律 睡眠周期；可能影响睡眠的神经或循环状况 脑电(EEG)或SPECT；以及最近使用的物质 可能会影响睡眠模式、脑电和/或SPECT。 受试者将经历适应之夜，基线之夜，PSD之夜， 在睡眠实验室里度过一个标准录音的恢复之夜 蒙太奇。数据将使用Delta Pass系统(周期-幅度)进行分析 分析。)受试者将在基线期间接受HMPAO脑SPECT检查 和PSD的下午。主观和临床医生管理的情绪和 抑郁评定量表将在标准时间段进行 基准日和恢复日以及私营部门司司长之夜。 这项研究采用3×2混合设计，分为3组(抑郁应答者， 抑郁的无反应者和对照组)和2种情况(基线和 在PSD之后。)修改后的HDRS-17有所下降(例如，省略了第4-6项(睡眠)) 16%(体重减轻)和30%(PSD后)将作为标准 用于临床反应。PSG和SPECT数据将进行多变量分析 方差分析。

DESCRIPTION (Adapted from applicant's abstract): The primary purpose of the proposed series of investigations is to gain better understanding of the antidepressant effects of sleep deprivation by analyzing polysomnography (PSG) before and after a night of PSD in depressed patients compared to normal controls. The secondary aim of the project involves analyzing SPECT cerebral blood flow (CBF) data in these subjects for correlations with clinical changes. The investigator predicts: 1) depressed responders will show increased rapid eye movement latency, increased slow wave sleep, and increased sleep efficiency following PSD; 2) responders' abnormal CBF distribution will become less abnormal after PSD and 3) the magnitude of such changes will correlate with the intensity of clinical response. Subjects will consist of physically healthy men and women diagnosed with major depression (unipolar) with baseline 17-item Hamilton Depression Rating Scale (HDRS-17) > 16. Normal controls will be matched for age and gender. Exclusion criteria include other psychiatric disorders; pregnancy; conditions which might be exacerbated by SD; sleep disorders; irregular sleep cycle; neurological or circulatory conditions which could affect electroencephalography (EEG) or SPECT; and recent use of substances which could affect sleep pattern, EEG, and/or SPECT. Subjects will undergo an adaptation night, a baseline night, a night of PSD, and a "recovery" night in the sleep laboratory with standard recording montage. Data will be analyzed with the Delta Pass system (period-amplitude analysis.) Subjects will undergo cerebral SPECT with HMPAO during baseline and PSD afternoons. Subjective and clinician-administered mood and depression rating scales will be administered at standard times during baseline and recovery days and during the PSD night. The study, a 3 X 2 mixed design, has 3 groups (depressed responders, depressed nonresponders, and controls) and 2 conditions (baseline and following PSD.) A drop in modified HDRS-17 (e.g., omitting items 4-6 (sleep) and 16 (weight loss) > 30 percent following PSD will be used as a criterion for clinical response. PSG and SPECT data will be analyzed by multivariance analysis of variance.